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Rosati D, Mastino P, Romeo M, de Soccio G, Pentangelo D, Petrella C, Barbato C, Minni A. Taste and Smell Alterations (TSAs) in Cancer Patients. Diseases 2024; 12:130. [PMID: 38920562 PMCID: PMC11203271 DOI: 10.3390/diseases12060130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Recently, smell and taste disorders have seen renewed interest, as these symptoms are frequent complications of SARS-CoV-2 infection, since approximately 60% of patients affected by COVID-19 have shown olfactory and gustatory alterations. Otolaryngology pays attention to taste and smell abnormalities (TSAs), especially when associated with oncology. TSAs are common symptoms in people affected by cancer, yet they are ignored and underestimated. The clinical outcome of TSAs in cancer evidences the importance of identifying them with chemotherapy or radiotherapy in general, and they are associated with many types of cancer. We recognize the findings of the literature on TSAs in cancer, evaluating how it is important to consider and identify these disorders concerning reduced food enjoyment or inappropriate nutrient intake, and modulating the nutritional status, quality of life, and impact of therapy. This review aims to critically evaluate and recognize the assessment and clinical perspectives of taste and smell disorders in a cancer population.
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Affiliation(s)
- Davide Rosati
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Pierluigi Mastino
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Martina Romeo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Giulia de Soccio
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Daniele Pentangelo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Antonio Minni
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
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Mazzoleni B, Ferrari G, Caccialanza R, Cattani D, Savioni F, Ferrante S, Lopane D, Dacomi A, Coldani C, Tomaiuolo G, Anastasi G, Mancin S. Pharmacological strategies and nutritional supplements for managing dysgeusia among chemotherapy patients: A systematic review. Clin Nutr ESPEN 2024; 63:20-30. [PMID: 38900642 DOI: 10.1016/j.clnesp.2024.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 05/12/2024] [Accepted: 05/31/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND/OBJECTIVE Among the side effects of chemotherapy, there is dysgeusia, which is an alteration or damage to the taste perception that negatively impacts the biopsychosocial sphere of the patient. Therefore, it is important to recognize and manage it appropriately. The objective of this study is to identify clinical pharmacological strategies to reduce dysgeusia in chemotherapy patients. METHODS A systematic literature review was conducted following the PRISMA guidelines between February and May 2023, utilizing PubMed, Embase, Cochrane Library, CINAHL, and the British Nursing Database. Methodological quality and bias risk assessment were performed using the JBI framework, while evidence certainty was evaluated using the Oxford OCEBM methodology. RESULTS Out of 1225 consulted records, 12 articles were included. The results underscore the efficacy of diverse pharmacological interventions in mitigating dysgeusia among chemotherapy patients. These include zinc supplementation with a daily dosage ranging between 50 and 220 mg (p ≤ 0.005), lactoferrin at 250 mg thrice daily (p < 0.001), delta-9-tetrahydrocannabinol at 2 mg per day (p < 0.05), and cannabidiol at 150 mg per day (p = 0.04). All studies analysed showed a low risk of bias. The zinc and Delta-9-Tetrahydrocannabinoid treatment proved particularly promising, compared to the other treatments considered, where sample sizes were smaller and the placebo effect was not always clear. CONCLUSION Among the various pharmacological strategies identified, those that appear most promising concern the integration of zinc and Delta-9-Tetrahydrocannabinoid. Future studies should further explore the treatments identified in this review to expand the evidence base in this relatively underexplored field.
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Affiliation(s)
- Beatrice Mazzoleni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | | | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | | | | - Diego Lopane
- IRCCS Humanitas Research Hospital, Rozzano Milan, Italy
| | | | | | | | - Giuliano Anastasi
- Department of Trauma, AOU G. Martino University Hospital, Messina, Italy
| | - Stefano Mancin
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
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Dismore LL, Taylor LL, Aujayeb A, Hurst C, Swainston K. Patients with mesothelioma and their carer's experience of diet and appetite: A qualitative insight from the Help-Meso Study. J Hum Nutr Diet 2024; 37:717-725. [PMID: 38583133 DOI: 10.1111/jhn.13301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/29/2024] [Accepted: 03/04/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND People living with mesothelioma have a high symptom burden that can affect dietary intake and the development of malnutrition, subsequently impacting on patient-related and treatment outcomes. The present study aimed to develop a better understanding of the experiences of diet and appetite in people living with mesothelioma and their informal carers. METHODS Twenty-three participants took part in semistructured interviews including 12 people living with mesothelioma (10 pleural and 2 peritoneal) aged 56-83 years and 12 informal carers, predominantly their spouses. Open ended questions focussed on experiences of appetite and diet, as well as approaches to maintain adequate food intake. Thematic analysis was applied. RESULTS Four themes were generated that included unintentional weight loss and poor appetite during diagnosis and when undergoing medical intervention. Participants managed their appetite and diet by taking each day at a time and this was influenced by the physical and emotional experiences of mesothelioma. The informal carer took on the lead role of managing their relatives' diet and implemented their own nutritional strategies and there were challenges with dietary advice. CONCLUSIONS Appetite was viewed as a multidimensional experience and was grounded within the biopsychosocial model. The findings offer important insights into opportunities informing the development of effective interventions that provide meaningful benefits for individuals living with mesothelioma and their family.
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Affiliation(s)
- Lorelle L Dismore
- Innovation, Research and Development, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, Rake Lane, North Shields, UK
| | - Leah L Taylor
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, Rake Lane, North Shields, UK
| | - Avinash Aujayeb
- Respiratory Department, Northumbria Healthcare NHS Foundation Trust, North Tyneside Hospital, Rake Lane, North Shields, UK
| | - Christopher Hurst
- AGE Research Group, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne NHS Foundation Trust and Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Katherine Swainston
- School of Psychology, Population and Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
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Rong H, Li F, Liu C, Zhou L, Zhong H, Li L, Xiao T, Xiao R, Chen X. Nutritional Management of Lung Cancer Patients Undergoing Chemotherapy: A Qualitative Exploration of Patients' and Healthcare Professionals' Perspectives. Semin Oncol Nurs 2024:151657. [PMID: 38816314 DOI: 10.1016/j.soncn.2024.151657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVES To describe the experiences of lung cancer patients undergoing chemotherapy in nutrition management and the problems in the process of implementing nutrition management for patients by healthcare professionals. METHODS This is a qualitative descriptive study. Qualitative data were collected through semistructured interviews with lung cancer patients undergoing chemotherapy (N = 16) and healthcare professionals (N = 24) from the oncology department at three tertiary grade A hospitals. RESULTS Three themes emerged from the patients' interviews: deficiency in nutritional management capabilities; barriers to implementing nutritional management; incentives to implementing nutritional management. Five themes emerged from the healthcare professionals' interviews: insufficient attention to nutritional management of lung cancer patients undergoing chemotherapy; lack of standardization in nutritional management; inadequate support for nutritional management; weak multidisciplinary awareness; poor compliance from patients and their families. CONCLUSIONS The nutritional management of lung cancer patients undergoing chemotherapy is a complicated and vital process that requires the joint efforts of healthcare professionals and patients. Formulating corresponding strategies from multiple perspectives is suggested to provide targeted nutritional guidance for patients. IMPLICATION FOR NURSING PRACTICE This study can help nurses better understand the nutritional management needs and challenges of patients to provide individualized nutritional guidance to patients. Meanwhile, the study also found the existing problems of nutrition management in clinical work, which can help nurses to reflect on and better participate in the nutrition management of patients.
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Affiliation(s)
- Huan Rong
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China; Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, China
| | - Fangyi Li
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Chunmei Liu
- Chengdu Seventh People's Hospital, Sichuan, Chengdu, China
| | - Linyu Zhou
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Hongyue Zhong
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Li Li
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Tian Xiao
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Ruihan Xiao
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China
| | - Xiaoju Chen
- School of Nursing, Chengdu Medical College, Sichuan, Chengdu, China.
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Al-Amouri FM, Badrasawi M. Taste alteration and its relationship with nutritional status among cancer patients receiving chemotherapy, cross-sectional study. PLoS One 2024; 19:e0302990. [PMID: 38723006 PMCID: PMC11081316 DOI: 10.1371/journal.pone.0302990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
The aim of this study is to determine the prevalence of taste alterations (TAs) during chemotherapy and their association with nutritional status and malnutrition. In addition to the associated factors with TA, including sociodemographic health-related factors and clinical status, and to investigate coping strategies to manage TA. A multicenter cross-sectional design study was conducted on 120 cancer patients aged at least 18 who had been undergoing at least one round of chemotherapy. TAs were evaluated using the chemotherapy-induced taste alteration scale (CiTAS), the malnutrition universal screening tool (MUST) was used for nutritional screening, the antineoplastic side effects scale (ASES) was used for subjective assessment of chemotherapy side effects, and the Charlson comorbidity index (CCI) was used for comorbidity assessment. SPSS21 software was used to analyze the data, and the independent T-test and one-way ANOVA test were used to determine the association between TAs and a variety of related variables. The prevalence of TAs was 98.3%. Among participants, 48.3% were at low risk of malnutrition, 20% at medium risk, and 31.7% at high risk. Malnutrition risk was associated with taste disorders (p<0.05). Patients' age, gender, educational level, and physical status were associated with TAs (p<0.05). Type of cancer, chemotherapy regimen, and number of chemotherapy cycles were also associated with TAs (p<0.05). A variety of antineoplastic side effects were associated with TAs (p<0.05), including nausea, vomiting, dry mouth, sore mouth and throat, excessive thirst, swallowing difficulty, appetite changes, weight loss, dizziness, lack of energy, disturbed sleep, anxiety, and difficulty concentrating. TAs were associated with an increased number of comorbidities, and individuals with diabetes, pulmonary diseases, and hypertension were associated with TAs (P<0.05). Patients in this study rarely practice self-management strategies to cope with TAs. A high prevalence (98.3%) of TAs in cancer patients receiving chemotherapy was found, and it was linked to a variety of negative outcomes. Chemotherapy-induced TAs are an underestimated side effect that requires more attention from patients and health care providers.
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Affiliation(s)
- Fatima Masoud Al-Amouri
- Department of Nutrition and Food Technology, An-Najah National University, Nablus, Palestine
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
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Loves R, Green G, Joseph-Frederick Z, Palmert S, Plenert E, Schechter T, Tomlinson D, Vettese E, Zahra S, Zupanec S, Dupuis LL, Sung L. Describing taste changes and their potential impacts on paediatric patients receiving cancer treatments. BMJ Support Palliat Care 2023; 13:e382-e388. [PMID: 34049968 DOI: 10.1136/bmjspcare-2021-002951] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/12/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Taste changes are common among paediatric patients receiving cancer treatments although specific descriptions and associations are uncertain. Primary objective was to describe the number of paediatric patients receiving cancer therapies who experienced taste changes, its impact on food intake and enjoyment of eating, and coping strategies. METHODS This was a cross-sectional study that included English-speaking paediatric patients aged 4-18 years with a diagnosis of cancer or haematopoietic stem cell transplantation recipients receiving active treatment. Using a structured interview, we asked participants about their experience with taste changes, impacts and coping strategies. The respondent was the paediatric patient. RESULTS We enrolled 108 patients; median age was 11 years (IQR 8-15). The taste changes reported yesterday or today were food tasting bland (34%), bad (31%), different (27%), bitter (25%), extreme (19%), metallic (15%) or sour (12%). Taste changes were associated with decreased food intake (31%) and decreased enjoyment in eating (25%) yesterday or today. The most common coping strategies were eating food they liked (42%), eating strong-tasting food (39%), drinking liquids (35%), brushing teeth (31%) and sucking on candy (25%). Factors significantly associated with food tasting bad were as follows: older age (p=0.003), shorter time since cancer diagnosis (p=0.027), nausea and vomiting (p=0.008) and mucositis (p=0.009). CONCLUSIONS Among paediatric patients receiving cancer treatments, taste changes were common and were associated with decreased food intake and enjoyment in eating. Common coping strategies were described. Reducing nausea, vomiting and mucositis may improve taste changes.
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Affiliation(s)
- Robyn Loves
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Gloria Green
- Division of Clinical Dietetics, The Hospital for Sick Children, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Zakia Joseph-Frederick
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Sasha Palmert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Erin Plenert
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Tal Schechter
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Deborah Tomlinson
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Emily Vettese
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Serena Zahra
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
| | - Sue Zupanec
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - L Lee Dupuis
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Department of Pharmacy, The Hospital for Sick Children, Leslie Dan Faculty of Pharmacy at the University of Toronto, Toronto, Ontario, Canada
| | - Lillian Sung
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
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Wang M, Xu Y, Wu Y, Liu C, Chen Y, Hua D, Liu Q. Evaluating the efficacy of auricular acupuncture for chemotherapy-induced taste alterations: A pilot randomized controlled trial. Eur J Oncol Nurs 2023; 67:102458. [PMID: 37951073 DOI: 10.1016/j.ejon.2023.102458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 10/06/2023] [Accepted: 10/27/2023] [Indexed: 11/13/2023]
Abstract
PURPOSE Irrespective of the development of acupuncture-based interventions, clinical evidence regarding their efficacy remains controversial owing to issues with the study design and an unclear risk of bias. This study aimed to evaluate the efficacy of auricular acupuncture in managing taste alterations in patients with cancer undergoing platinum-based chemotherapy. METHODS We conducted a pilot randomized controlled trial involving 73 patients randomly assigned to an auricular acupuncture or a control group. The primary outcome was the severity of chemotherapy-induced taste alterations, and the secondary outcomes included quality of life and negative emotions of the patients. RESULTS A total of 49 participants completed the study. Compared to the control group, patients in the auricular acupuncture group showed significant reductions in discomfort, general taste alterations, and total scores on the Chemotherapy-induced Taste Alteration Scale (all p < 0.05). Furthermore, we observed significant improvements in quality of life, including physical function (p = 0.007), role function (p = 0.006), emotional function (p = 0.016), nausea and vomiting (p = 0.021), appetite loss (p = 0.046), and significant improvements in anxiety and depression (p < 0.01). CONCLUSIONS Our findings suggest that auricular acupuncture may be a beneficial intervention for managing chemotherapy-induced taste alterations in patients with cancer receiving platinum-based chemotherapy. It may also contribute to improvements in quality of life and negative emotions. However, these results are preliminary, and further evaluation with larger randomized controlled trials is necessary.
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Affiliation(s)
- Meng Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Yongping Xu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Yaoyao Wu
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China.
| | - Chao Liu
- Department of Epidemiology and Statistics, Bengbu Medical College, Bengbu, China.
| | - Ying Chen
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
| | - Dong Hua
- Department of Oncology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, China.
| | - Quan Liu
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi, China.
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Buttiron Webber T, Briata IM, DeCensi A, Cevasco I, Paleari L. Taste and Smell Disorders in Cancer Treatment: Results from an Integrative Rapid Systematic Review. Int J Mol Sci 2023; 24:ijms24032538. [PMID: 36768861 PMCID: PMC9916934 DOI: 10.3390/ijms24032538] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
Taste and smell disorders (TSDs) are common side effects in patients undergoing cancer treatments. Knowing which treatments specifically cause them is crucial to improve patients' quality of life. This review looked at the oncological treatments that cause taste and smell alterations and their time of onset. We performed an integrative rapid review. The PubMed, PROSPERO, and Web of Science databases were searched in November 2022. The article screening and study selection were conducted independently by two reviewers. Data were analyzed narratively. Fourteen studies met the inclusion criteria and were included. A high heterogeneity was detected. Taste disorders ranged between 17 and 86%, while dysosmia ranged between 8 and 45%. Docetaxel, paclitaxel, nab-paclitaxel, capecitabine, cyclophosphamide, epirubicin, anthracyclines, and oral 5-FU analogues were found to be the drugs most frequently associated with TSDs. This review identifies the cancer treatments that mainly lead to taste and smell changes and provides evidence for wider studies, including those focusing on prevention. Further studies are warranted to make conclusive indication possible.
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Affiliation(s)
| | - Irene Maria Briata
- Division of Medical Oncology, E.O. Galliera Hospital, 16128 Genoa, Italy
| | - Andrea DeCensi
- Division of Medical Oncology, E.O. Galliera Hospital, 16128 Genoa, Italy
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London E1 4NS, UK
| | - Isabella Cevasco
- Department of Health Professions, E.O. Galliera Hospital, 16128 Genoa, Italy
| | - Laura Paleari
- Research, Innovation and HTA Unit, (A.Li.Sa.) Liguria Health Authority, 16121 Genoa, Italy
- Correspondence: ; Tel.: +39-010-5484-243
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Mozaffar B, Ardavani A, Muzafar H, Idris I. The Effectiveness of Zinc Supplementation in Taste Disorder Treatment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Nutr Metab 2023; 2023:6711071. [PMID: 36937245 PMCID: PMC10017214 DOI: 10.1155/2023/6711071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/06/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction Food taste and flavour affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect the taste, but the efficacy of zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. Methods We searched four electronic bibliographical databases: Ovid MEDLINE, Ovid Embase, Ovid AMAD, and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. There were no restrictions on the publication date to facilitate the collection and identification of all available and relevant articles published before 7 February 2021. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. Results In total, we included 12 randomized controlled trials with 938 subjects. The intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc, and acetate), and the pooled results of the meta-analysis of subjects with idiopathic and zinc-deficient taste disorder indicate that improvements in taste disorder occurred more frequently in the experimental group compared to the control group (RR = 1.38; 95% CI: 1.16, 1.64, p=0.0002). Zinc supplementation appears to confer a greater improvement in taste perception amongst those with chronic renal disease using zinc acetate (overall RR = 26.69, 95% CI = 5.52-129.06, p < 0.0001). The doses are equivalent to 17 mg-86.7 mg of elemental zinc for three to six months. Conclusion Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency, idiopathic taste disorders, and in patients with taste disorders induced by chronic renal failure when given in high doses ranging from 68 to 86.7 mg/d for up to six months.
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Affiliation(s)
- Boshra Mozaffar
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
- 2Clinical Nutrition Department, Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Arash Ardavani
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
| | - Hisham Muzafar
- 3Department of Pharmacology and Toxicology, College of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Iskandar Idris
- 1MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, National Institute for Health Research Nottingham Biomedical Research Centre, Clinical, Metabolic and Molecular Physiology, University of Nottingham, Royal Derby Hospital, Derby, UK
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Milliron BJ, Klobodu C, Deutsch J, Martyn K, Dychtwald D, Riahi E, Carro S, Hisek T, Darcy N, Klassen AC. "Keep Your Chin Up, and Keep Eating": Perceptions of Barriers and Facilitators to Healthful Dietary Behaviors Among Individuals With Gastrointestinal Cancer and Caregivers. Cancer Control 2023; 30:10732748231208316. [PMID: 37914716 PMCID: PMC10623986 DOI: 10.1177/10732748231208316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND This study explored perceptions of barriers and facilitators to healthful dietary behaviors among patients with gastrointestinal (GI) cancer and their caregivers, including caregiver preparedness, patient and caregiver self-efficacy for symptom management, and other environmental, social, and familial factors that may serve as barriers and facilitators to healthful eating. METHODS Using a concurrent mixed methods cross-sectional study design, individuals with GI cancer receiving outpatient chemotherapy and their caregivers completed surveys, dietary assessments, and interviews. Caregiving preparedness, self-efficacy for symptom management, and dietary intake were assessed using validated instruments. Dietary quality was measured using the Healthy Eating Index (HEI)-2020. In-depth interviews explored barriers and facilitators to healthful eating, symptom management, and caregiver preparedness. RESULTS Twenty-seven patient-caregiver dyads completed study activities (N = 54). Dietary quality scores ranged from 26 to 81, with a median score of 43 for patients and 42 for caregivers. Thematic analysis identified three barriers to healthful eating: caregiver self-efficacy and preparedness, caregiver needs are neglected, and nutrition as a source of conflict. Overall self-efficacy scores (Mdn, [IQR]) were 69.1 (45.0) for caregivers and 75.6 (34.1) for patients. Caregiver preparedness score was 2.99 ± .87; problem areas were identified, including addressing emotional needs, fluctuating eating habits, advanced disease progression and making care activities pleasant. Despite the challenges, three main facilitators were identified: increased awareness and value of nutrition, influential others, and positive coping. CONCLUSION Our findings suggest the importance of developing interventions that increase nutrition-related preparedness among caregivers and self-efficacy for managing treatment side effects. Future research should continue to explore the relationship between positive coping and dietary behaviors. While engaging patients and caregivers together during dietary interventions is a promising modality, strategies for maintaining personal nutrition-related goals when facing contrasting priorities between patients and caregivers should be addressed.
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Affiliation(s)
- Brandy-Joe Milliron
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Cynthia Klobodu
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Jonathan Deutsch
- Department of Food and Hospitality Management, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Karon Martyn
- Asplundh Cancer Pavilion, Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA, USA
| | - Dan Dychtwald
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Emily Riahi
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Shawn Carro
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Taylor Hisek
- Department of Nutrition Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Natalie Darcy
- Asplundh Cancer Pavilion, Sidney Kimmel Cancer Center, Jefferson Health, Willow Grove, PA, USA
| | - Ann C Klassen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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11
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Avancini A, Belluomini L, Borsati A, Riva ST, Trestini I, Tregnago D, Dodi A, Lanza M, Pompili C, Mazzarotto R, Micheletto C, Motton M, Scarpa A, Schena F, Milella M, Pilotto S. Integrating supportive care into the multidisciplinary management of lung cancer: we can't wait any longer. Expert Rev Anticancer Ther 2022; 22:725-735. [PMID: 35608060 DOI: 10.1080/14737140.2022.2082410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Due to important achievements in terms of diagnostic and therapeutic tools and the complexity of the disease itself, lung cancer management needs a multidisciplinary approach. To date, the classical multidisciplinary team involves different healthcare providers mainly dedicated to lung cancer diagnosis and treatments. Nevertheless, the underlying disease and related treatments significantly impact on patient function and psychological well-being. In this sense, supportive care may offer the best approach to relieve and manage patient symptoms and treatment-related adverse events. AREAS COVERED Evidence report that exercise, nutrition, smoking cessation and psychological well-being bring many benefits in patients with lung cancer, from both a physical and socio-psychological points of view, and potentially improving their survival. Nevertheless, supportive care is rarely offered to patients, and even less frequently these needs are discussed within the multidisciplinary meeting. EXPERT OPINION Integrating supportive care as part of the standard multidisciplinary approach for lung cancer involves a series of challenges, the first one represented by the daily necessity of specialists, such as kinesiologists, dietitians, psycho-oncologists, able to deliver a personalized approach. In the era of precision medicine this is an essential step forward to guarantee comprehensive and patient-centered care for all patients with lung cancer.
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Affiliation(s)
- Alice Avancini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy.,Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Lorenzo Belluomini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Anita Borsati
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Silvia Teresa Riva
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Ilaria Trestini
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Daniela Tregnago
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Alessandra Dodi
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Massimo Lanza
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Cecilia Pompili
- Thoracic Surgery Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Renzo Mazzarotto
- Section of Radiotherapy, Department of Surgery and Oncology, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Claudio Micheletto
- Pulmonary Unit, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Massimiliano Motton
- Radiology Department, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Aldo Scarpa
- Section of Pathology, Department of Diagnostic and Public Health, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Federico Schena
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Michele Milella
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
| | - Sara Pilotto
- Section of Oncology, Department of Medicine, University of Verona School of Medicine and Verona University Hospital Trust, Verona, Italy
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12
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Taste alterations during neo/adjuvant chemotherapy and subsequent follow-up in breast cancer patients: a prospective single-center clinical study. Support Care Cancer 2022; 30:6955-6961. [PMID: 35538327 DOI: 10.1007/s00520-022-07091-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 04/22/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Dysgeusia and taste alterations (TAs) are side effects of cytotoxic chemotherapy and affect patients' quality of life; however, the prevalence, types, and duration of TAs and their potential relationship with other clinical disturbances are not well-described. Our primary aim was to prospectively evaluate the characteristics of TAs in early breast cancer (EBC) patients during (neo)adjuvant chemotherapy and up to 1 year after its completion. METHODS From April 2014 to June 2018, 182 EBC patients entered the study and received (neo)adjuvant chemotherapy, mostly with taxane and anthracycline-containing regimens (65% of cases). A dietitian performed TAs assessment through the Common Terminology Criteria for Adverse Event v4.0 (CTCAE) and the Chemotherapy-induced Taste Alteration Scale (CiTAS) questionnaire during chemotherapy and follow-up according to defined time points: at baseline (T0, before starting chemotherapy); at the first follow-up visit, (T1, 2 months after starting chemotherapy); at the final follow-up visit (T2, 1 week after completing chemotherapy); after that, every 3 months up to 12 months. RESULTS Dysgeusia was reported by 69.8% of patients at T1 and declined subsequently; salty flavor distortion was the most frequently reported TA (51.6% of cases). CiTAS was significantly different between T0 and T2 (p < 0.001). Dysgeusia occurred more frequently in patients reporting nausea, mucositis, diarrhea, and appetite modification. CONCLUSIONS TAs are common but transient during chemotherapy and occurred frequently with other distressing gastrointestinal side effects. The assessment of these side effects is crucial in managing EBC patients during (neo)adjuvant chemotherapy.
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13
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Özkan İ, Taylan S, Eroğlu N, Kolaç N. The Relationship between Malnutrition and Subjective Taste Change Experienced by Patients with Cancer Receiving Outpatient Chemotherapy Treatment. Nutr Cancer 2021; 74:1670-1679. [PMID: 34328368 DOI: 10.1080/01635581.2021.1957485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Taste changes and malnutrition are two important problems in patients with different types of cancer. This study was conducted to evaluate the relationship between malnutrition and subjective taste changes experienced by cancer patients receiving outpatient chemotherapy. The study used a cross-sectional design and was carried out with 1382 patients with cancer receiving outpatient chemotherapy. Of the patients, 63.1% experienced taste changes. It was determined that 8.8% of patients had malnutrition according to the Mini Nutritional Assessment. The mean scores of patients experiencing malnutrition and being at risk for malnutrition from all sub-dimensions of The Chemotherapy-induced Taste Alteration Scale (CiTAS) were found to be higher than the patient group evaluated to have normal nutrition. It was determined that a unit increase in the scores of the parageusia and phantogeusia subscales of the CiTAS increased the risk of malnutrition by 3.36 times (%95 CI= 2.68-4.02). In line with these results, we recommend that patients with cancer receiving chemotherapy should be routinely evaluated in terms of taste changes in clinical practice and that they should be followed up in terms of malnutrition in the presence of taste changes.
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Affiliation(s)
- İlknur Özkan
- Internal Medicine Nursing Department, Kumluca Faculty of Health Sciences, Akdeniz University, Kumluca-Antalya, Turkey
| | - Seçil Taylan
- Surgical Nursing Department, Kumluca Faculty of Health Sciences, Akdeniz University, Kumluca-Antalya, Turkey
| | - Nermin Eroğlu
- Faculty of Health Sciences, Fenerbahçe University, Istanbul
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14
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Kinjo T, Kanda K, Fujimoto K. Effects of a self-monitoring intervention in breast cancer patients suffering from taste alterations induced by chemotherapy: A randomized, parallel-group controlled trial. Eur J Oncol Nurs 2021; 52:101956. [PMID: 33940487 DOI: 10.1016/j.ejon.2021.101956] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/11/2021] [Accepted: 03/28/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE This study evaluates the effect of a self-monitoring intervention on taste alterations in breast cancer patients undergoing outpatient chemotherapy. METHODS The study was a randomized controlled trial. Thirty-four participants were divided into two groups: a self-monitoring (SMG) group (n = 17) and a control group (CG) (n = 17). A conceptual framework was developed with reference to the components of self-management, cognitive behavioral therapy, and the concepts of self-monitoring. Interventions were based on this framework. SMGs recorded their taste symptoms as homework and worked with the researcher to set goals and provide feedback four times every three weeks. In the feedback, the researcher actively listened to the SMG about their feelings and coping strategies during the taste changes, and gave approval and praise for these. The implementation period was 9 weeks for each participant; the CG was provided with conventional nursing support. The intervention was evaluated by comparing the items of symptom improvement, quality of life (QOL), and self-efficacy between the groups before and after the start of the intervention using a scale score. Scale scores were also compared for recognition of taste changes, concerns during treatment, distress, and impacts on each treatment day. RESULTS SMG had significantly lower scores than CG for perceived change in taste (p = 0.009), and there was an interaction with CG (p = 0.008). SMG had also significantly lower scores than CG in concern during treatment (p = 0.015). CONCLUSION This study showed that a self-monitoring intervention reduced negative cognition of taste alterations and reduced discomfort. The results suggest that the self-monitoring intervention is effective nursing support for chemotherapy-induced taste alterations.
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Affiliation(s)
- Taeko Kinjo
- Gunma University Hospital Division of Nursing, 3-39-15, Showa-machi, Maebashi-shi, Gunma, 371-8511, Japan.
| | - Kiyoko Kanda
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan.
| | - Keiko Fujimoto
- Department of Nursing, Takasaki University of Health and Welfare, 501 Nakaorui-machi, Takasaki-shi, Gunma, 370-0033, Japan.
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15
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Silva IMV, Donaduzzi LC, Perini CC, Couto SAB, Werneck RI, de Araújo MR, Kurahashi M, Johann ACBR, Azevedo-Alanis LR, Vieira AR, Couto-Souza PH. Association of xerostomia and taste alterations of patients receiving antineoplastic chemotherapy: A cause for nutritional concern. Clin Nutr ESPEN 2021; 43:532-535. [PMID: 34024566 DOI: 10.1016/j.clnesp.2021.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 02/11/2021] [Accepted: 03/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND & AIMS The symptoms of xerostomia and taste alteration are adverse effects which frequently occur in patients under chemotherapy and once associated they can potentially impair their nutritional status. The aim of this study was to investigate the association of xerostomia and taste alterations in patients being treated by neoplastic chemotherapy. METHODS Fifty patients scheduled to receive neoplastic chemotherapy were followed for their first two chemotherapy cycles for solid tumors and the Chemotherapy-Induced Taste Alteration Scale (CiTAS) was adopted. Xerostomia was defined by the presence of dry mouth complaints reported by the patients and signs of hyposalivation identified during the intraoral examination. RESULTS Of the 50 patients, 33 were women, mean age; 61,48 ± 9,07 years, and 17 were men, mean age; 57,35 ± 11,50 years. The most common tumor was located in the breast affecting 15 patients (30%). The Mann-Whitney test showed that the mean scores of CiTAS were significantly higher for those patients who reported having xerostomia when compared with those without xerostomia after the first two chemotherapy cycles. The cofounding variables such as age, smoking habits and use of antidepressants were not statistically associated with taste alterations (p > 0.05). CONCLUSIONS Taste alterations were worse for patients who complained of xerostomia during the first two cycles of antineoplastic chemotherapy and the association of both symptoms can potentially impair their nutritional status and quality of life.
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Affiliation(s)
- Isabela M V Silva
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Liziane C Donaduzzi
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Carla C Perini
- Department of Nutrition, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Soraya A B Couto
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Renata I Werneck
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Melissa R de Araújo
- School of Dentistry, Universidade Federal do Paraná (UFPR), Av. Prefeito Lothário Meissner, 632 - Jardim Botânico, 80210-170, Curitiba, Brazil
| | - Maikol Kurahashi
- Oncology Service of the Santa Casa Hospital of Curitiba, Praça Rui Barbosa, 694 - Centro, 80010-030, Curitiba, Brazil
| | - Aline C B R Johann
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Luciana R Azevedo-Alanis
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil
| | - Alexandre R Vieira
- Clinical Research for the School of Dental Medicine, University of Pittsburgh, 335 Sutherland Dr., Pittsburgh, PA, 1526, USA
| | - Paulo H Couto-Souza
- Department of Dentistry, School of Life Sciences, Pontifícia Universidade Católica do Paraná, Imaculada Conceição, 1155, Prado Velho, 80215-901, Curitiba, Brazil.
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16
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Ellender G, Coveney J. Flavor alterations in cancer treatment: Extrinsic factors as a means of augmentation. Clin Nutr ESPEN 2021; 43:76-89. [PMID: 34024568 DOI: 10.1016/j.clnesp.2021.02.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/01/2021] [Accepted: 02/24/2021] [Indexed: 01/13/2023]
Abstract
Flavor, comprising taste, smell and somatosensory inputs, is commonly altered in patients undergoing chemotherapy resulting in malnutrition leading to cachexia. A narrative review considered taste and smell alterations associated with malignancies treated using chemotherapy and the various interventions proffered to lessen alterations. Many of the currently used interventions directed towards enhancing intrinsic factors of food appeared ineffective in encouraging intake of adequate nutrition to ward off complications of malnutrition. Counselling is used in some cases with positive results. The use of extrinsic influences commensurate with the principles of food behavior and gastronomy are considered as a means of providing purpose to patients to accommodate flavor loss which when integrated with counseling and appropriate intrinsic factors are potentially a means of curtailing malnutrition and enhancing the psychological status of the patient. The close association between the cephalic phase responses (CPRs) and the control of eating and digestive behaviors is multifaceted, and when the influences of taste and smell are diminished, other contributing factors guiding CPRs may compensate a deficit. The need for the application of a consistent lexicon is essential when describing taste and smell alterations.
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Affiliation(s)
- Graham Ellender
- Adelaide Dental School, The University of Adelaide, South Australia 5000, Australia.
| | - John Coveney
- Global Food, Culture and Health, Flinders University, Bedford Park, South Australia 5042, Australia.
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17
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Kaizu M, Komatsu H, Yamauchi H, Yamauchi T, Sumitani M, Doorenbos AZ. Characteristics of taste alterations in people receiving taxane-based chemotherapy and their association with appetite, weight, and quality of life. Support Care Cancer 2021; 29:5103-5114. [PMID: 33604787 PMCID: PMC8295069 DOI: 10.1007/s00520-021-06066-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 02/09/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE There is limited evidence on the effect of chemotherapy-associated taste alteration. This study aimed to evaluate taste alteration characteristics in patients receiving taxane-based chemotherapy and investigate the association of taste alterations with appetite, weight, quality of life (QOL), and adverse events. METHODS This cross-sectional study evaluated 100 patients receiving paclitaxel, docetaxel, or nab-paclitaxel as monotherapy or combination therapy. Taste alterations were evaluated using taste recognition thresholds and severity and symptom scales. Taste recognition thresholds, symptoms, appetite, weight, and adverse events were compared between patients with and without taste alterations, and logistic regression analysis was performed to identify risk factors. RESULTS Of the 100 patients, 59% reported taste alterations. We found significantly elevated taste recognition thresholds (hypogeusia) for sweet, sour, and bitter tastes in the taste alteration group receiving nab-paclitaxel (p = 0.022, 0.020, and 0.039, respectively). The taste alteration group reported general taste alterations, decline in basic taste, and decreased appetite. Neither weight nor QOL was associated with taste alterations. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were significantly associated with taste alterations. CONCLUSIONS Almost 60% of patients receiving taxane-based regimens, especially docetaxel, reported taste alterations. Taste alteration affected the patient's appetite but did not affect the weight or QOL. Docetaxel therapy, previous chemotherapy, dry mouth, and peripheral neuropathy were independent risk factors for taste alterations.
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Affiliation(s)
- Mikiko Kaizu
- Keio University Graduate School of Health Management Course for Nursing, 35 Shinanomachi, Shinjyuku-ku, Tokyo, 160-8582, Japan.
| | - Hiroko Komatsu
- Japanese Red Cross Kyushu International College of Nursing, 1-1 Asty Munakata-City, Fukuoka, 811-4157, Japan
| | - Hideko Yamauchi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Teruo Yamauchi
- Division of Medical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Masahiko Sumitani
- Department of Pain and Palliative Medicine, The University of Tokyo Hospital, 7-3-1 Hongou, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Ardith Z Doorenbos
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.,Palliative Care, University of Illinois Cancer Center, 845 S. Damen Ave, Chicago, IL, 60612, USA
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18
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Chang A, Chung NC, Lawther AJ, Ziegler AI, Shackleford DM, Sloan EK, Walker AK. The Anti-Inflammatory Drug Aspirin Does Not Protect Against Chemotherapy-Induced Memory Impairment by Paclitaxel in Mice. Front Oncol 2020; 10:564965. [PMID: 33381448 PMCID: PMC7768078 DOI: 10.3389/fonc.2020.564965] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 11/11/2020] [Indexed: 11/22/2022] Open
Abstract
Inflammation has been proposed to play a causal role in chemobrain which—if true—would represent an opportunity to repurpose existing anti-inflammatory drugs for the prevention and treatment of chemobrain. Here, we show that the chemoagent paclitaxel induces memory impairment and anhedonia in mice within 24 h of treatment cessation, but inflammation is not present until 2 weeks after treatment. We find no evidence of brain inflammation as measured by cytokine analysis at any time point. Furthermore, treating with aspirin to block inflammation did not affect paclitaxel-induced memory impairment. These findings suggest that inflammation may not be responsible for memory impairment induced by paclitaxel. These results contrast with recent findings of a causal role for inflammation in cancer-induced memory deficits in mice that were prevented by treatment with oral aspirin, suggesting that cognitive impairment in cancer patients undergoing treatment may arise from multiple convergent mechanisms.
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Affiliation(s)
- Aeson Chang
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - Ni-Chun Chung
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - Adam J Lawther
- Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Randwick, NSW, Australia
| | - Alexandra I Ziegler
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - David M Shackleford
- Centre for Drug Candidate Optimisation, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia
| | - Erica K Sloan
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia
| | - Adam K Walker
- Drug Discovery Biology Theme, Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia.,Laboratory of ImmunoPsychiatry, Neuroscience Research Australia, Randwick, NSW, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, East Melbourne, VIC, Australia.,School of Psychiatry, University of New South Wales, Randwick, NSW, Australia
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19
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Bernstein IA, Roxbury CR, Lin SY, Rowan NR. The association of frailty with olfactory and gustatory dysfunction in older adults: a nationally representative sample. Int Forum Allergy Rhinol 2020; 11:866-876. [PMID: 33131203 DOI: 10.1002/alr.22718] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/19/2020] [Accepted: 10/05/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfaction and gustation are associated with age-related decline. Deficits in these chemosenses have been associated with significant comorbidities. Meanwhile, frailty, defined as a reduced physiological reserve, is well correlated with mortality and worse health outcomes. We sought to analyze a nationally representative patient population to determine the association between chemosensory dysfunction and frailty. METHODS Cross-sectional analysis of U.S. National Health and Nutrition Examination Survey (NHANES) 2013-2014 was performed, using multivariate logistic regression to examine the association between chemosensory dysfunction and frailty in adults aged ≥40 years (n = 3547). Self-reported olfactory dysfunction (sOD) and gustatory dysfunction (sGD), and measured olfactory dysfunction (mOD) and gustatory dysfunction (mGD) were assessed for all participants. Frailty was operationalized using a 39-item frailty index (FI) and stratified into 4 groups using validated cutoffs. RESULTS Participants with sOD and mOD had significantly higher mean FI scores (sOD: 0.18 vs 0.13, p < 0.001; mOD: 0.20 vs 0.14, p < 0.001), whereas subjects with sGD, but not mGD, had higher mean FI scores (sGD: 0.21 vs 0.13, p < 0.001; mGD: 0.14 vs 0.14, p = 0.953). Multivariate logistic regression demonstrated frail participants had significantly greater odds of sGD (odds ratio [OR] 4.11; 95% confidence interval [CI], 3.46 to 4.88), sOD (OR 2.35; 95% CI, 1.98 to 2.78), and mOD (OR 1.58; 95% CI, 1.22 to 2.05), but not mGD (OR 1.21; 95% CI, 0.91 to 1.61). This association was strongest in the frailest group. CONCLUSION Self-reported chemosensory dysfunction and mOD are independently associated with measures of frailty, suggesting a novel method to assess or predict frailty.
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Affiliation(s)
- Isaac A Bernstein
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Christopher R Roxbury
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Chicago Medicine, Chicago, IL
| | - Sandra Y Lin
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Nicholas R Rowan
- Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD
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20
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Enriquez-Fernandez BE, Martinez-Michel L, Thorlakson J, Wismer WV. Patient-reported taste change assessment questionnaires used in the oncology setting: A narrative review. Eur J Oncol Nurs 2020; 47:101775. [PMID: 32559713 DOI: 10.1016/j.ejon.2020.101775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/12/2020] [Accepted: 05/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Patient-reported questionnaires to assess taste changes (TC) among patients with cancer and the common domains or aspects assessed by those questionnaires are identified in this narrative review. Taste changes are a prevalent symptom experienced by patients with cancer that impact food choice and enjoyment, reduce food intake, and diminish quality of life. Appropriate assessment is essential to detect and manage this symptom. METHOD A systematic search of relevant databases between 1999 and 2018 yielded 1959 articles; 38 articles were included in the review. RESULTS Seventeen questionnaires designed specifically to assess patient-reported taste changes among patients with cancer are described in the review. Seven domains were identified among the questionnaires; the most frequently assessed domain was the description of the taste change in 14 questionnaires). Timeframe, scoring, number of items and domains, and item phrasing varied greatly among questionnaires and the approach to domain and item evaluation was inconsistent. Comprehensive questionnaires (n = 7) assessed five or more domains to characterize the taste change experience. The majority of questionnaires have been cited only once or twice. CONCLUSION Patient-reported taste change assessment in oncology has been achieved by a large number of diverse questionnaires; no standard tool or approach is used. Development of a question bank of validated or standardized taste change modules or items may strengthen the consistency and applicability of research in this area.
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21
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Asano S, Sawatari H, Mentani H, Shimada Y, Takahashi M, Fudano K, Sasaki K, Niitani M, Tanabe K, Kataoka T. Taste Disorders: Effect of Education in Patients With Breast Cancer Receiving Chemotherapy. Clin J Oncol Nurs 2020; 24:265-271. [PMID: 32441675 DOI: 10.1188/20.cjon.265-271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND For patients with breast cancer treated with certain chemotherapy regimens, taste disorders associated with those regimens can negatively affect quality of life. OBJECTIVES This study evaluated the effects of taste disorder-related education on meal satisfaction and sense of taste in Japanese women with breast cancer undergoing chemotherapy. METHODS A sample of 53 newly diagnosed women with breast cancer scheduled for chemotherapy treatment were randomly assigned to the control or intervention (nurse-provided education about chemotherapy-associated taste disorders) group. Meal satisfaction and sense of taste were assessed using a visual analog scale. FINDINGS The proportions of patients with meal dissatisfaction and impaired sense of taste were lower in the intervention group than in the control group. Although meal dissatisfaction and impaired sense of taste recovered in the intervention group two months after protocol completion, they did not recover in the control group. Providing education to women with breast cancer scheduled for chemotherapy treatment can affect patients' experience of treatment-associated taste disorders.
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Affiliation(s)
| | | | | | | | | | - Kazumi Fudano
- Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital
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Jain R, Coss C, Whooley P, Phelps M, Owen DH. The Role of Malnutrition and Muscle Wasting in Advanced Lung Cancer. Curr Oncol Rep 2020; 22:54. [PMID: 32409907 PMCID: PMC8717049 DOI: 10.1007/s11912-020-00916-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Malnutrition, cancer cachexia, and sarcopenia often co-occur in patients with advanced cancer and are associated with poorer response to chemotherapy and reduced survival. Here, we evaluate the current literature regarding the role of nutrition and these associated conditions in patients with advanced lung cancer. RECENT FINDINGS While rates of malnutrition are high, nutritional intervention studies have generally been limited by small sample sizes. Novel strategies such as home-based meal delivery may have promise. While no therapy is approved for cancer cachexia, ghrelin agonists and other targeted therapies have yielded promising data in clinical trials. Recent data also suggest that obesity may improve immunotherapy responsiveness. Malnutrition and associated muscle wasting are clearly negative prognostic markers in advanced lung cancer. Patients with malnutrition should be urgently referred for dietary counseling and guidelines for nutritional support should be followed. Optimal treatment of these syndromes will likely include nutrition and anti-cachexia interventions used in combination.
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Affiliation(s)
- Rishi Jain
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA.
| | - Chris Coss
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Peter Whooley
- Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Mitch Phelps
- Division of Pharmaceutics and Pharmacology, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Dwight H Owen
- Division of Medical Oncology, The Ohio State University James Comprehensive Cancer Center, Columbus, OH, USA
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Pang D, Qian L, Chen ZJ, Lu Q, Heitkemper MM, Yang P, Jin S. Psychometric properties of the Chinese version of the chemotherapy-induced taste alteration scale. Eur J Oncol Nurs 2019; 42:7-13. [PMID: 31446267 DOI: 10.1016/j.ejon.2019.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 07/15/2019] [Accepted: 07/19/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE The chemotherapy-induced taste alteration scale (CiTAS) is a reliable and valid instrument to comprehensively assess patients' taste alterations in an easy way. We aimed to translate it and test its psychometric properties among Chinese cancer patients undergoing chemotherapy. METHOD A convenience sample of 227 cancer patients were recruited in a tertiary cancer hospital in Beijing. The Chinese version of the CiTAS (C-CiTAS) was developed via rigorous translation methods. An exploratory structural equation model (ESEM) was used to test its construct validity. Correlations between the C-CiTAS scores and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 scores were calculated for convergent validity. The overall taste alterations scale (OTAS) score was used to test its discriminant validity. Reliabilities were also examined. RESULTS The majority of patients undergoing chemotherapy experienced minor to mild taste alterations. The current factor analysis results using the ESEM supported the original factor solution of the CiTAS, and no item of the CiTAS was dropped. The C-CiTAS demonstrated good construct validity, convergent validity and discriminant validity. The Cronbach's alphas of the C-CiTAS were 0.900 for the overall scale and from 0.570 to 0.857 for the four subscales. Its test-retest reliability was 0.815 (p < 0.01). CONCLUSIONS The Chinese version of the CiTAS is a reliable and valid instrument to evaluate cancer patients' Chemotherapy-induced taste alterations in China.
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Affiliation(s)
- Dong Pang
- School of Nursing, Peking University, PR China.
| | | | | | - Qian Lu
- School of Nursing, Peking University, PR China.
| | | | - Ping Yang
- School of Nursing, Peking University, PR China.
| | - Sanli Jin
- School of Nursing, Peking University, PR China.
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24
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Chemotherapy alters subjective senses of taste and smell but not dietary patterns in Japanese lung cancer patients. Support Care Cancer 2019; 28:1667-1674. [DOI: 10.1007/s00520-019-04958-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/19/2019] [Indexed: 12/11/2022]
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25
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Haller H, Wang T, Lauche R, Choi KE, Voiß P, Felber S, Cramer H, Ataseven B, Kümmel S, Paul A, Dobos G. Hypoglossal acupuncture for acute chemotherapy-induced dysgeusia in patients with breast cancer: study protocol of a randomized, sham-controlled trial. Trials 2019; 20:398. [PMID: 31272494 PMCID: PMC6610893 DOI: 10.1186/s13063-019-3525-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 06/15/2019] [Indexed: 11/22/2022] Open
Abstract
Background Distortion of taste sensations is a common chemotherapy-induced side effect; however, treatment evidence is limited. Pilot data indicated that acupuncture might be able to improve symptoms of dysgeusia. Thus, the aim of this study is to investigate the effects and side effects of hypoglossal acupuncture in the treatment of dysgeusia in patients with breast cancer undergoing chemotherapy. Methods/design The study is a randomized controlled trial comparing a single verum acupuncture treatment with two active comparators: sham acupuncture and dietary recommendations. Sample size calculation revealed a total of 75 patients pending an alpha of 0.05, a power of 0.8, and an estimated effect size of 0.80. Patients with breast cancer undergoing platinum- or taxane-based chemotherapy will be included if they present with phantogeusia (abnormal taste sensations without an external oral stimulus) with an intensity of 4 points or above on an 11-point numeric rating scale (NRS). The primary outcome is phantogeusia; secondary outcomes include parageusia (abnormal taste of food), hypogeusia (reduced taste sensations), hypergeusia (increased taste sensations), xerostomia (dry mouth), stomatitis, appetite, and functional impairment. All outcomes will be assessed at baseline and prior to the next chemotherapy administration using an 11-point NRS for each. All adverse events will be recorded. Discussion The results of this study will demonstrate the extent to which hypoglossal acupuncture may influence the intensity of and functional impairment due to chemotherapy-induced dysgeusia. Trial registration Clinical Trials.gov, NCT02304913. Registered on 19 November 2014.
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Affiliation(s)
- Heidemarie Haller
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany.
| | - Taige Wang
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany.,Breast Unit, Kliniken Essen-Mitte, Essen, Germany
| | - Romy Lauche
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney (UTS), Sydney, Australia
| | - Kyung-Eun Choi
- Institute for Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR) at the Faculty of Human Sciences and the Faculty of Medicine of the University of Cologne, Cologne, Germany
| | - Petra Voiß
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany.,Breast Unit, Kliniken Essen-Mitte, Essen, Germany
| | - Sabine Felber
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany.,Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Holger Cramer
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany
| | - Beyhan Ataseven
- Department of Gynecology and Gynecologic Oncology, Kliniken Essen-Mitte, Essen, Germany
| | | | - Anna Paul
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany
| | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Am Deimelsberg 34a, 45276, Essen, Germany
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Dysgeusia in patients with cancer undergoing chemotherapy. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2019. [DOI: 10.1016/j.ajoms.2019.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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